Provider Demographics
NPI:1114227451
Name:VANTREASE, TERESA ANN (RN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:VANTREASE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2165 HIGHWAY 25 W
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37074-3646
Mailing Address - Country:US
Mailing Address - Phone:615-374-4310
Mailing Address - Fax:
Practice Address - Street 1:1005 UNION SCHOOL RD
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2084
Practice Address - Country:US
Practice Address - Phone:615-206-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000112421163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health